Table Of Content

UMASS/AMHERST 312DbE301t,S'=]b7'=32 GOyERHKLm DOCUMEA COLLECTION ' ' 2 2 1998 University of H^assachus^ffs ^ecosilory Copy CHOICE iHEHI The fastest growing segment of the elderly population is made up of people aged 85 and over, according to the U.S. Census Bureau. Elder CHOICE was developed by the Massachusetts Housing Finance Agency in conjunction with the Executive Offices of Communities and Development, . Elder Affairs, and Health and Human Services to provide a housing option for elderly Massachusetts residents that fills the gap between independent living and a nursing- home setting. CHOICE ijjflflifflifjffllililimj^^ Elder ''Service'Plan" On-site supportive services are the central feature of The Massachusetts Housing Finance Agency CHOICE Elder assisted-living developments. Elder (MHFA) introduces Elder CHOICE, a new housing CHOICE residents are frail elders who are no longer willing, or possibly able, to live alone and who may alternative for frail elderly residents of the need help v/ith activities ofdaily living (ADLs), such Commonwealth. Elder CHOICE provides construc- as bathing, dressing, eating, continence, or moving around. In addition, they may require a helping hand tion and permanent financing for the creation with other routine activities such as food preparation, housekeeping, laundry, transportation, or reminders of a special type of housing called assisted living. about when to take medication. This new housing option offers supportive services Service plans are generally structured in a standard to elders who can no longer live independently. package ofbasic services, available to all residents for On-site, individualized services allow elders to a flat monthly charge. In addition, enhanced services may be made available at an additional charge. While maintain the independence of living in their service programs may vary within each development, CHOICE own rental apartments while obtaining the help all Elder developments offer the following basic services: they need. Personal care (assistance with bathing, continence, dressing, eating, and moving around) Housekeeping and maintenance, laundry service, Program Guidelines medical monitoring, and transportation Three meals per day MHFA is accepting proposals for financing through 24-hour emergency response Elder CHOICE from highly qualified development Service coordination and case management teams. Proposed teams must have demonstrated perfor- Individualized care plans ensure that each resident's mance in the design, development, and operation of specific needs are met through a program that maxi- housing with services for the frail elderly. Experienced mizes the elder's independence, privacy, and choice of service providers are integral to the successful operation ofan Elder CHOICE development. The strongest services. proposals will display: Expertise in the delivery and coordination of on-site services Proven development capability Strong market demand Superior site location Quality building design Ongoing financial feasibility Mr. Ben S. is 78 years old and feels lonely and isolated since his wife's death two years ago. Often he doesn't fix a meal Site Location & Building Design because "nothing tastes good." He neglects personal grooming CHOICE Elder developments are best located in qual- and wears the same clothes day ity commercial/residential areas with good visibility after day. A homemaker/home and access to major transportation networks. Proximity health aide visits him three to shopping, health care services, and religious/cultural times per week for set blocks of centers are important to residents and their families. two hours, but what Mr. S. Building designs and finishes are tailored to the needs needs is someone to help him and preferences offrail elders. The architecture and for shorter time periods several interior design should present a domestically scaled, times each day. residential environment while providing for a service Mr. S. would do well in the infrastructure (administrative offices, commercial social and supportive atmos- kitchen, and dining areas). In particular: phere of an Elder CHOICE Project sizes range from 30 to 100 units for best development. efficiency and rent-up. Apartment types may include studios/alcoves, one- and two-bedroom units. All units include a bathroom, kitchenette, lockable entry door, and individual climate controls. Effective and efficient building layouts should be developed in close consultation with the designated service provider so that plans and specifications support mar- keting activities and service delivery. Market Analysis Strong market demand is essential for Elder CHOICE developments. An independent market feasibility analysis must be included in all applications for financing. This analysis should include: The target market The market area Proposed rents and service charges Level ofaffordability Evidence oflocal support The involvement oflocal health care providers, agencies and organizations serving the elderly, and community leaders will enhance the assisted-living CHOICE program in Elder developments. Mrs. Anna L. is 82 years old. Physically she feels well. Lately, though, her family disturbed is .f'-w«»aiS5^?is by her "forgetfulness." Mrs. L. %A Cost-Effective Alternative repeatedly leaves the front door unlocked and goes to Assisted living offers a cost-effective alternative to bed. She often cannot remem- institutionalization for those w^ho need personal ber when she has done tasks. assistance or oversight but who do not need the skilled Her family no longer feels com- medical care that nursing homes provide. fortable leaving her alone and is afraid her memory losses and Affordabiiity confusion threaten her safety. At least 20% ofthe units in a development financed At an Elder CHOICE develop- through Elder CHOICE must be reserved for low- ment, Mrs. L. would receive income residents. Low-income is defined as a house- daily oversight and would not hold receiving less than 50% ofthe area median have to pay for the unneeded income. Sponsors may target low-income occupancy medical care of a nursing to elders who qualify for the Medicaid Group Adult home. Foster Care Program (GAFC), which provides funds for personal care services. HOME, Public and private equity programs such as Community Development Block Grants, and the Federal Home Loan Bank's Affordable Housing Program grants may also be used to make rent and service charges more affordable. . < *.. .7' K,,j^ ,1 >. ' ' ' A>.'*.,V. ,' ": •'*>' ' '„ :' -:'. ;?,j;.^';,^:v:/ ' /"v ' -'' ''" ?^'A*';;V'A. ,y5^^''^>-^'^"^^-r. "•''.-) n^V.f»--J,?v-„V;.i_' • „: ,.• >->;,- »||VBf|ii'-.'K^'r,-T,.i--A'f ./',w.«»'-_•.'-(..; ,. ',•••14*,:-' i^<V'<>i.'V ','.''^'J'i't--'••,',• ' ''.''>,/*' . ' •^.V ':.'' ". ,''.•1-' ' -i' "* !,' V. ' ,;'A<ji<A ;.. sy^''"'''''' '- ' % . ' .';.,';./; ')i.« ?t'y%vr'''' Mrs. Helen T. is an 89-year-old widow who hated the idea of giving up her house. But house- hold chores were getting more and more difficult for her. One Financing Available day, Mrs. T. fell and broke her MHFA hip. Since then, she needs a lot has designed a financing package for assisted of help getting around. It is living. Through Elder CHOICE, the Agency offers now clear to Mrs. T. and her construction and permanent financing at below- daughter that she cannot live market interest rates through the sale oftax-exempt alone. bonds. Non-recourse loans ofup to 90% loan-to-value are available with a 30-year term and amortization A decision to move to an and minimum debt service coverage of 1 15%. MHFA assisted-living facility is often can also allocate 4% Low-Income Housing Tax brought on by an event, such as Credits to eligible properties. an accident in the home. The Development Team The development team must have proven success in the development ofassisted living or similar types of properties, such as nursing or rest homes, elderly housing with supportive services, or residential hotels. Teams include: Developer/Owner Manager/Service Provider Architect General Contractor Hi f^V^^ i.ul: m:^^'-'^^^^^^ •rH^ V.3'^